Fergus

Services

Each lawyer offers services in their areas of practice, while working with other members of the SmithValeriote legal team to serve all the needs of our clients. We are dedicated to growth and the expansion of our services to meet the needs of all clients promptly and efficiently.

Resources

We have a long and distinguished history of providing Guelph and area residents and businesses with high-quality, personal and professional legal services. Our team has written a number of articles, which are included in this site.

Smith Valeriote Lawyers Blog | Smith Valeriote LLP Law Firm Guelph

What’s an IME and Why Is It Making the News Lately?

What is an IME?

IME stands for Insurance Medical Examination. If you are receiving any type of injury or disability benefit, chances are you have been forced to attend a medical examination by an examiner selected by the insurance company.

Why are you sent to an IME?

The reason behind sending you to an “IME” is for the insurance company to determine whether they will pay for or continue to pay for your treatment, care, or income benefits.

Why are they making the news?

Simple. Corruption. According to the January 2017 MPP Advisor...

"IMEs have become a billion dollar industry. Insurance companies force approximately 50% of all accident victims to go through the IME process. For those victims who are assessed, insurers actually spend more money on the assessments than they do on treatment to help the victim get better! For benefit claims arising from accidents since January 1, 2011 (when the insurance industry started keeping statistics), insurers have spent over $600,000,000 on IMEs!"

But why does that mean Corruption?

Due to the economic advantage of writing a report favourable to the insurance company, the reports are heavily biased in favour of the insurance company that bought it.

But how has this made its way to the news?

The case that brought this tainted insurance practice to public light (as those of us in the industry have been aware for years) was Platnick v. Bent 2016. In this case, the lawyer advised OTLA members of unfair and biased practices that were happening in her case. It was reported that under cross examination an IE neurologist has testified that a large and critically important section of his report had been removed without his knowledge or consent. As it turned out Dr. Platnick had drafted the executive summary and omitted critical information from the final report. The correspondence further notes that this was not an isolated event.

This effectively means that the assessment doctor was tailoring the medical reports to suit the needs of the insurance company to deny the injured person benefits.

The National Post reported,

“When Canadians suffer potentially life-altering injuries in accidents, the medical assessments carried out for insurers can be crucial to determining what kind of benefits they obtain."

But a new court ruling casts a murky light on that process, concluding that an Ontario doctor likely misrepresented the views of specialists so it was easier for an insurance company to deny a victim benefits.

The Toronto Star has reported that the College of Physicians and Surgeons of Ontario is now investigating the doctor who wrote the misleading report about a car accident victim to benefit and insurance company.

It is a very sad truth. And this is not new. In 2014, the FAIR Association of Victims for Accident Insurance Reform wrote a letter to Ontario’s MPP’s titled “Does Ontario no longer want an honest justice system?" In this letter it states that there is,

“Increasing evidence that Ontario’s auto accident victim’s medical files are routinely being altered to suit Ontario’s insurers need to save money. Portions of medical reports have been removed, manipulated or even changed entirely without the author’s knowledge or consent in order to minimize victim injuries.”

The letter goes on to include portions of court and arbitration cases that have identified these issues in the past. The letter was intended as a call to action. We are all still waiting.